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Acupunture as self treatment for tinnitus

Q:  I am a muscian and DJ, looking for safe and effective treatment for tinnitus and long term hearing damage from working in loud venues. I do a little acupressure, and would like to learn acupuncture too as a self treatment. How much training do I need in order to perform self treatment safely and effectively?

A:  There are two issues here. The first is whether acupuncture is really an effective treatment for tinnitus. As you might imagine, we have been asked several times about tinnitus, and most recently we replied:

The fact sheet which we have on the website

is quite upbeat about a number of small studies, but our clinical experience is not as good, with tinnitus among the more intractable conditions with which patients present. In a recent answer, to which we can probably not add a great deal more, we said:

A. Tinnitus is one of the more intractable conditions which people seek acupuncture treatment for. Our Tinnitus fact sheet, found at lists a small amount of research which suggests that acupuncture may help, but there have been no significant trials which provide solid evidence. It is also fair to say that many practitioners are very cautious about taking on patients for whom tinnitus is the primary problem. It is quite easy to spend considerable time and money and be no better off than when you started, and the individual case reports in the tinnitus sufferers' magazines often have the same shape.

However, what many practitioners do find when treating people with tinnitus is that while the noise remains largely unchanged their ability to cope with it seems to improve. Evidence for this is largely anecdotal, though, and it would be wise to discuss carefully with any future practitioner whether they think that they might be able to help. In all events we would recommend that frequent and regular reviews of outcomes and progress are essential.

We don't think you can say more than this. There are two or three clearly identifable patterns in Chinese medicine, described as syndromes, where tinnitus is a specific named symptom which frequently appears, and it is possible, if your tinnitus has arisen as a part of the syndrome, that there may be some help which acupuncture treatment may offer. An experienced practitioner should be able to make a very straightforward determination on whether this is the case. Overall, however, there is not a great deal of cause for optimism about getting rid of the unwanted noise.

As far as self treatment is concerned, opinion in the profession is divided. There was a paper published some years ago

which summarised the arguments for and against self treatment, although the last few years have seen an increase in the use of self-treatment for people who need regular top-ups after chemotherapy and the like. We believe that while the risk of an adverse event is very low, as indeed it is for any treatment with acupuncture, it is asking quite a lot of a patient to observe the rigorous conditions which we ourselves have to follow when we are needling. Disposal of the needles and any clinical waste is just one major headache among several. The fact that someone has agreed to accept the risk is all very well, but our experience is that this perception changes very quickly if something does go wrong. We have seen this when people treat friends; hell hath no fury like a friend with a bruise.

It is also fair to day that we do not necessarily think that formula treatments for named conditions are the best way to perform acupuncture. Our work is evolutionary and dynamic, the very thing which makes it so difficult to fit with the so-called 'gold standard' research model. Formula treatments tend not to work for everyone, and lack that very thing which makes acupuncture such a powerful intervention, the fact that the treatment plan and treatment is unique to the individual patient.

That said, we hate to discourage someone from using acupuncture because although the likelihood of making a big difference with acupuncture for tinnitus is low, it can and does happen. Your best bet is to try to find a practitioner local to you who uses ear acupuncture and uses stud needles or ear seeds which can be left in place and manipulated regularly to achieve the necessary effect. They can also review your treatment on a fairly regular basis to ensure that everything is going to plan. This is probably better, in our view, than self-needling.

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